Perinatal audit. Are experts biased by knowledge of outcome? A controlled study

Perinatal audit is a method widely used for quality assurance in medicine. In clinical medicine, experiments have revealed that physicians' prior knowledge and expectations may bias their assessments. This study examined whether experts in perinatal audit were biased in their evaluation of perinatal and neonatal care when they had knowledge of the outcome. A panel of experts evaluated the quality of care in 48 infants who died in the neonatal period and 48 paired infants who survived it. The 48 pairs were randomly allocated to two groups. In the first group, the outcome of neonatal death or neonatal survival appeared in the case histories, whereas in the second group the outcome was blind. There were no differences in the assessment of quality of antenatal, delivery, and neonatal care comparing the result of the evaluation between the cases with knowledge of the outcome and the cases without knowledge of outcome. Our results indicate that the experts were not biased by the knowledge of outcome when they assessed the quality of peri- and neonatal care.